Mercer Urges Congress to Tackle Healthcare Costs 

Testifying at a congressional hearing on April 26, Tracy Watts, Mercer’s US health policy leader, urged lawmakers to tackle high health care costs and voiced support for several related policy proposals. Watts also cited extensive Mercer research underscoring the health care affordability challenge for both employers and employees. Watts testified on behalf of both Mercer and the American Benefits Council.

The House Education and the Workforce Committee’s Subcommittee on Health, Education, Labor, and Pensions hearing, titled “Reducing Health Care Costs for Working Americans and Their Families,” featured a number of priorities from House Republicans’ health policy agenda. That agenda is informed in part by two sets of comments submitted by Mercer last year to the House GOP “Healthy Future Task Force.”

Echoing a recommendation in Mercer’s comments, Watts advocated for bipartisan legislation – the Telehealth Benefit Expansion for Workers Act (HR 824) – that would permanently allow all employers, regardless of size, and health insurers to provide stand-alone telehealth benefits to all employees. When offered as an “excepted benefit,” stand-alone telehealth coverage meets a very specific need for certain employers, especially in the retail, hospitality and healthcare industries, Watts explained. Furthermore, stand-alone telehealth coverage that’s allowed to qualify as an excepted benefit would not jeopardize an individual’s potential eligibility to receive federal premium tax credits to purchase individual Marketplace health insurance.

“We work with a large restaurant chain that extended telehealth to its nonenrolled, part-time population. They view the telehealth benefit as a critical way to provide access to behavioral health services and appropriate medication when an employee who is not enrolled in the health plan gets sick,” she noted.

The current, temporary policy created by the regulators in response to the pandemic treats telehealth and remote care services like an excepted benefit, eliminating the need for the coverage to comply with many ERISA and Affordable Care Act (ACA) group health plan mandates (e.g., first-dollar coverage of ACA-mandated preventive care). This temporary policy is tied to the public health emergency (PHE) and allows large employers (generally those with 51+ employees) to offer telehealth arrangements only to employees (or their dependents) who are not eligible for coverage under any other group health plan offered by that employer like part-time or seasonal workers. Despite being tied to the PHE, however, the guidance allows employers to offer this benefit for the duration of the plan year beginning before May 11, 2023 (i.e., the end of the PHE).

Unlike the current temporary policy, the Telehealth Benefit Expansion for Workers Act would permanently let all employers, regardless of size, offer excepted-benefit stand-alone telehealth arrangements to all employees (including benefit-eligible optouts), not just those ineligible for benefits.

Watts emphasized that stand-alone telehealth is also “hugely valued by employees” but that Congress needs to make the benefit permanent to keep employers offering it. She shared Mercer survey data indicating that, because of legislative uncertainty, the number of respondents using this strategy dropped to 7% in 2023 from 17% in 2022.

While there’s bipartisan support for stand-alone telehealth, some at the hearing expressed reservations. Rep. Susan Wild, D-PA, said she is a “huge fan” of telehealth but has concerns the plans could mislead beneficiaries into thinking they have comprehensive health benefits. Patients may only understand the lack of comprehensive coverage when they realize they need an in-person visit with a provider for a service that is not be covered under a telehealth-only plan, she said.

Citing the urgency of making health care more affordable, Watts also expressed support for legislation that would crack down on dishonest provider billing practices and help protect against state efforts to limit the ability of employers sponsoring self-funded plans to buy stop-loss insurance. Her testimony pointed to Mercer survey data showing that 68% of responding employees say they have challenges getting health care for themselves and their family, while two-thirds of large employers said that “improving healthcare affordability” is an important or very important health program priority.

It’s unclear when the Committee might consider and advance legislation, but further action is expected at some point later this year.